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The merger craziness picks up where it left off last week, but mercifully only Cristina and Callie are really still crazed with it. Callie spends the hour putting off actually talking to the Chief about getting her job back and instead just keeps practicing the talk using Arizona as a sounding board. Arizona finally gets sick of it and knocks a little sense back into Callie so that she faces up to it like an adult. When Callie goes to see Richard, she is the first person to acknowledge that this must be a really hard time for him and that seems to do the trick, as he welcomes her right back to Seattle Grace as an attending. Cristina doesn't have such an easy time of it. She spends the hour skulking around, trying to find (or steal) a surgery and generally freaking out. She finally walks in on Derek and Hunt talking to Mark about a penile implant surgery he's about to do, and without knowing what the surgery entails she immediately asks to get in on it. Delighted, Mark takes her up on it and while she's not happy when she realizes what it is, she manages to suck it up and do the job with dignity, at least. She then goes to Richard and says that as long as there's no good cardio attending to teach her, he might as well cut her because he needs to make cuts, and she needs to learn and isn't learning if she can't actually get on any surgeries, especially cardio. That's left unresolved, but I think it's safe to say that one of the show's best actors isn't going anywhere.
Izzie has a patient who has his own kind of horrible cancer, and when she and Hunt open him up they find he's too far gone to be saved. Hunt closes him up and is going to send him on his way to do the last bit of living he can, but Izzie is certain that since she beat incredible odds, they could do a risky surgery and help save this guy too. The patient is really cool and nice, with a great long-term girlfriend, and of course right before his surgery he realizes he shouldn't wait for the right moment to propose and should just do it as soon as possible. We all know what this means, right? He winds up dying during surgery, and while Hunt takes the blame (and beats himself up for letting himself be talked into the surgery in the first place) he warns Izzie that she can't be both a patient and doctor on the job, she has to just be a doctor and be realistic when looking at the odds.
The star patient of the day is none other than Thatcher Grey. Lexie gets a call from a worried neighbor and finds him in a bad way, so she brings him in and as soon as he gets through the door of the ER, he throws up blood all over Meredith's shoes. Though he has been sober for 90 days, he's in liver failure, and as he hasn't been sober for a year he can't get on the transplant list. Lexie offers to be his donor but she's not a match, and so in desperation she pulls Mere's file and realizes that she is. In tears, she begs Meredith with all her heart to save him, acknowledging that he was a horrible father to Mere but pleading that he was wonderful to Lexie and it would be for her. Meredith thinks about it and finally agrees, but Thatcher at least has the grace to turn her down. She thinks she's off the hook but after a lot of thinking and tears and talking and pacing, she tries again and points out that she's doing this because she loves Lexie as a sister, not him as a father. He accepts, and we have one of the more ingenious ways to write someone out of a show for maternity leave as now Mere will need a month of recovery time after the successful surgeries.
Want more? The full recap starts right below!It's a beautiful morning in Seattle, and Mere voiceovers while we see Alex get up (in some very tiny shorts -- good morning, indeed!) and go about his morning routine in the cramped, now kind of disgusting trailer. "We begin life with few obligations. We pledge allegiance to the flag, we swear to return our library books. But as we get older we take vows, we make promises, we get burdened by commitments: to do no harm, to tell the truth and nothing but, to love and cherish 'til death do us part. So we just keep running up a tab until we owe everything to everybody and suddenly think, what the..." It's cut off by a girlish scream. Alex, who had to move piles of crap out of the way just to get to the shower, dries himself off with napkins after nothing else is available, makes coffee, and then brushes his teeth in the kitchen sink. When the water doesn't work he instead uses an old beer to rinse out his mouth. Ew, that visual makes me now need to rinse the taste of vomit out of my own mouth. Once he's dressed, he opens up the door and sees a bear up on his hind legs, thus the screaming like a girl, matched by a roar from the bear.
Because she's snotty and she sucks, Izzie asks him (once he's at work) if he is sure it wasn't a deer, as the bucks can get really big. Alex isn't in the mood and as Izzie pauses to tell a patient to ice and elevate something, he yells about how he had to throw a raw steak and run in the other direction just to get to his car. It's always classy when they yell in front of the patients. Again, Richard -- maybe make a note, if you're trying to improve things. He declares that they have to move, but over another patient she asks him where they'd go as they barely make $30,000 a year. The patient is remarkably expression-free for all of this. Alex suggests going back to Meredith's, but Izzie won't do it since they are married and making a new life for themselves. She then tries to sell him on how great it is to be around fresh air and birds, but he counters that he loves plumbing. It's at this point that they go to the end of the bed and talk in hushed tones, and Izzie tells him that while she loves it at Meredith's, she can't move backwards after everything that has happened. Seriously? That's private but your salary isn't? Alex just grudgingly nods.
The Chief is meeting with his attendings in a conference room, and a great breakfast spread has been laid out on the table. He tells them he knows things aren't easy and that they want answers, but he doesn't have them. Great, I'm glad we've had this meeting, bye! Derek tells Mark that Richard only did this to make himself feel better, and when Mark points out the good Danish Derek asks him if he knows how many nurses were fired for that Danish. The Mercy West people are going to be there in three days, which means more layoffs, and Richard asks them all to be leaders, promising answers when he has them. Every single person starts to yell questions and he just tells them if they'd like to make an appointment to discuss, they can. A bemused Derek watches all the chaos and then grabs himself a tasty pastry.
Cristina asks Mere about any possible surgeries and is disappointed to hear that one patient died before they could make it to the OR. She gripes about needing surgeries, because she's only had 100 hours in the OR that month and she's sure those with the most hours will be saved. Meredith is back to being calm and amused, and I'm fairly certain that as Cristina moans about being kicked off two services in one month, she wasn't guessing that her bestie's reaction would be a giggle. Meredith has got an optic glioma surgery coming up with Derek, so she is excited, while Cristina checks out both Stinky's and Izzie's patients nearby to see if she can poach anything. Izzie calls her on it and the two begin to argue but they're broken up by Lexie leading in a very ill-looking Thatcher, explaining that his neighbor noticed he wasn't getting his mail. Mere rolls her eyes as Thatcher mumbles congratulations for getting "married on a sticker." Mere assumes that Thatcher is just drinking again, but he swears that isn't the case and then proceeds to throw up blood all over Mere's shoes. Cristina says, almost admiringly, "Now that would be surgical."
Bailey has taken over Thatcher's care, and while he continues to vomit blood Lexie asks all sorts of questions and the residents all vie to help out. Bailey has no patience for it and just keeps Alex, kicking out a mad Izzie and Cristina. Lexie tries to convince Meredith that Thatcher made amends and isn't drunk, but Mere is skeptical and just walks away.
Meanwhile, Mark is burning something off of an elderly patient's skin. His name is Irving, and his son (Doc Abbott!) and daughter-in-law are there and couldn't be more condescending. Doc says to his wife that the nursing home staff should examine him for these spots when they bathe him, and when he points out that he bathes himself, the wife tells him too loudly, "Of course." They continue being jerks and finally Irving gets them to leave and go get him some coffee, reminding his loud-talking daughter-in-law that he's just old, not demented. Once they are gone, he admits he's not worried about the skin thing as he's dealt with them for years. He's really there because he wants a penile implant. Mark's a bit shocked and tells him that the first step is drug therapy, which he's happy to prescribe. But Irving tells him he's tried that and it never helped, and then his wife died and he stopped trying. But now he's dating a, "new gal from the east wing." She's younger, and he doesn't want to disappoint her. Mark understands that completely, but mentions that there are still safety questions given his age. Irving grouses about being old and then says of the golden years: "There's just got to be more to life than eating pudding and watching CSI. I mean, come on. Can you give an old man a working Johnson?" Mark laughs, but we don't hear an answer. However, I don't think Irving could have gotten a better doctor for the task at hand.
When Cristina compliments Izzie on her short, edgy hair, Izzie knows she's freaking out and asks how long it's been since she did a surgery, which is over a week. Hunt comes over to get Izzie for a particular case, which Cristina of course wants. Hunt just chuckles and tells Izzie about the guy, who has an abdominal sarcoma. Izzie leaves to go get him ready for surgery while Cristina complains to her boyfriend that she needs a surgery. Hunt defends his choice, pointing out that everyone seems too scared to work with Izzie, as if she'll break or something, and plus he needs someone with a light touch, who is good with patients. Cristina shoots back, "You want nice? I can be nice to a dying husk." He points out that isn't exactly the light touch he meant and heads off.
Meredith finds Derek and matter-of-factly informs him that her dad is dead. She then admits that she thought he was drinking but that the puking blood and disorientation probably mean end stage liver disease. She guesses he's either dead or needs a transplant, and admits she hopes it's the former because otherwise he'd be in the hospital for months. Alex walks up and says her name, and her face falls because she knows he's about to tell her that Thatcher needs a transplant. When Alex confirms it, Mere whimpers.
Indeed, Bailey tells Thatcher that he has end-stage cirrhosis, and while they can treat the symptoms, the only thing that will save his life is a transplant. When Lexie asks how it happened so fast, Alex snarks, "He bathed it in gin." Lexie is horrified but Thatcher defends him, saying he's right, except that it was scotch. The rub is that one can only get on the transplant list if they have been sober for a year, and Thatcher is only at 90 days. All of the doctors, Richard included, look on hopelessly until Lexie jumps in and says she'll do it. Thatcher is against it but Lexie won't let him argue, explaining that they only take a piece and it will regenerate. When Thatcher says he can't ask her to do it, she says that he's not asking, she's doing it, and if he wants a kidney that's his too. Mere just rolls her eyes.
Arizona and Callie are in the nursery with all the wee babies and Callie is chattering away, clearly for the umpteenth time, telling Arizona to play the Chief and she'll play Callie asking for her job back. Callie's got curly hair again today -- welcome back, curls! I missed you. I hate that somehow it was decreed that what is attractive is a smooth blowout, as I'm someone who loves the look of curly hair (though I don't have it myself -- jealous!) Arizona asks if she's really going to do it today, and Callie doesn't answer but reminds Arizona how humiliating it is to go crawling back to someone she told to screw himself in front of much of the hospital, and that she's sure he won't hire her back after already firing her once. Callie then brightly tries to call being a surgeon overrated, and offers to open a daycare until one of the babies pukes, to her disgust. Arizona tells her that she doesn't want her girlfriend moving to Cleveland to be a surgeon. (Although don't we already know that she could go to Portland?) Callie declares she's going to do it but then gets paged, and runs out promising to come back later. Arizona tells the baby that her girlfriend is moving to Cleveland.
Mark comes across Lexie sitting in the hallway and figures she came in on her day off to get in on an extra surgery. Defensively, she said she is, that she's giving her dad a piece of her liver. She quickly explains that he's sick and needs it so she's doing it, and then tells Stinky, who has been prepping her arm, to draw her blood. Mark's taken aback but she gets combative, and when he says that one doesn't jump into this, one takes time to consider it and they should talk about it she demands to know what there is to talk about. He reminds her that it's a major, life-threatening surgery but her answer is that her dad needs it. When Mark says he gets it, she cuts him off and icily informs him that she doesn't think he does. He reminds her that they are together and need to decide these things together; she can't go in for surgery and leave him a note. Sulkily, she mumbles that she would have paged him. But when Mark reminds her that he's her boyfriend, she just says that this is her dad. Stinky looks alarmed to be in the middle of it but finally forges ahead to draw her blood.
Izzie is in with her patient and when his girlfriend can't get the remote to work Izzie tells her to bang it on the table, an "insider trick." Her patient, Randy, is impressed and she gives him some more little tricks to make his stay more comfortable and explains that she was in with stage 4 melanoma. She then tells the woman, Angela, that she needs to give him a rectal exam so she might want to leave, mistaking her for Randy's wife. Angela makes jokes as she explains that they've been together for eight years, and when Randy tells her he was going to propose last year until he got distracted by cancer she tells him it's the best excuse in the book. She's totally good-natured about it, though, and when she leaves the room he tells Izzie the ring is at home in his mouth guard container, and he's just waiting for the right moment. Everyone who can see every twist of this upcoming story, raise your hand. Everyone? Nice.
Mark is showing Irving and his kids how the pump works, complete with pump located in the scrotum. When Irving repeats that to pump it he just needs to "squeeze the jewels," his embarrassed son can't keep quiet any longer. He yells about how he's being ridiculous at 82, but Irving asks if he isn't allowed to have a sex life and tries to get Mark to continue. Doc isn't having any of it, though, and yells at him (some of what Mark just yelled at Lexie) that this is a major surgery. Where it differs from Mark's earlier conversation is when he asks his dad if he wants to die over an erection. Irving calmly tells him, "Wars have been fought over an erection, son." Mrs. Doc, in her simpering tone, says that she knows this won't be covered by insurance and that he wants to use his savings to help Janie (presumably their daughter, his granddaughter) go to college. Awesomely, Irving says that he loves his granddaughter, but isn't it time they admit she's not going to college? "She's pretty, but she's not too sharp." I feel like we're seeing Mark Sloan in 40 years' time. When Doc starts to speak again Irving has had enough, yells that it's his money and he's going to spend it how he wants to. He and his wife saved for years for a rainy day, then she died before they could spend anything, and he thinks she'd be happy that he's doing something nice for himself. Doc expresses snide disbelief that she'd be proud about his, and Mark finally jumps in and says they have to run tests first. He suggests they calm down and then go from there.
Cristina is gazing sadly at the surgery board when Dr. Nelson comes up. Shamelessly, she starts flirting like she's a few shots into her evening at a bar. "I couldn't help but notice you have no resident on your somediddly bobbything surgery." He's flustered, and stammers that he heard she was hardcore into cardio. She breathily replies, "I can be hardcore into anything you want." It's kind of awesome. Nelson turns and sees Hunt watching this spectacle, so he flees, and Hunt asks if Cristina is really whoring herself out for surgeries. Cristina just tells him he forced her into it. He leaves as Mere comes up and declares biology to be crap, that DNA and RNA don't make someone your family. Cristina points out that in fact that's exactly what makes someone family, and Mere tells her about Thatcher needing a transplant. "Lexie volunteered like she just got asked for a dollar bill. I left the room. He's not my family." She then gets a page and expresses hope again that maybe Thatcher is dead now, and when she leaves Cristina looks after her, a bit worried.
Izzie and Hunt are in Randy's surgery, and Hunt is bummed to see that Randy's way worse off than he originally thought, as all of the scarring fused his organs together. I think there's literally nothing positive that can be taken from that, wow. Izzie remains upbeat, comments that it looks like someone poured a bottle of glue in his abdomen (true) and asks how they fix it. It's kind of annoying, like all her doctor instincts and reading people have just gone out the door while she's little miss optimistic about how they cure anything and everything. When Hunt tells her they don't, she suggests a couple of different things they won't try. Hunt is firm that trying to remove this would do him more harm than good, and that doctors have to know when to say when, which is what he's doing now.
Lexie, Bailey and Richard are waiting for her outside Thatcher's room, and when she asks (not totally concealing the hope in her voice) if he is dead, Lexie is confused and rather horrified. He's not dead, but Lexie is not a match. Mere asks about her sister, getting her name wrong in the process, and Lexie explains that she lives in Bahrain and has a history of something that doesn't make her eligible anyway. Richard jumps in to say they thought Mere should know before they tell him, just in case, and she thanks them. It appears she doesn't register at all that they are trying to ask her to get tested. Instead, she just leaves to go prep for her surgery. A very puffy Lexie opens her mouth to say something but doesn't, clearly perplexed at Mere's not Getting It.
Mere, though, did Get It and is just avoiding It. She's having the gang eat lunch in a lab so that they can hide from Lexie and her big sad eyes. Cristina asks if she wasn't a match, and Alex jumps in to remind Cristina that it's his case either way. Izzie asks if she is getting tested, and when Mere tells them she's not, as she barely knows him, they exchange looks and Cristina and Alex both try to talk her into it on account of Thatcher giving her the ultimate gift of life. Izzie calls them out on just desperately wanting a surgery and Cristina doesn't hide it: "Mama needs to cut." She's a junkie that desperately needs a fix. Izzie then tells Alex he's got some dirt on his neck but as the girls look at it, they realize it's a swollen tick. Alex lets loose his second girlish screams of the day as he yells at them to get it off of him while they just all gawk.
Mark and Irving are talking, and Irving says that while his kids think this is about vanity, he needs it. Mark tries to tell him that if this woman loves him, she'll understand. Irving counters that Mark doesn't understand this now, because he's young, but that one day he's going to wake up and find all of life's milestones are behind him. He hasn't wanted to make love to anyone in 20 years since his wife died, but one day they sat him at a table with Marian, and Mark finishes his sentence, that then he just knew. Irving tells him, "She's my tomorrow."
Mark's tomorrow comes out of her dad's room to talk to Bailey. Stuttering, but getting to the point quickly, she flat-out asks Bailey to lie to the transplant board and say that Thatcher has been sober for a year. The kid's got guts, that's for sure. Of course Bailey doesn't agree, pointing out that she has 15 other people on the list, none of whom drank themselves there. She asks if there are any other questions, and Lexie sheepishly shakes her head.
Cristina is taking the tick out the neck of a very embarrassed and squicked out Alex. She's all business and narrating each step of the process while Alex curls up in the fetal position to complain about their current living situation which involves things crawling all over them and squirrels on the roof. Apparently there also isn't plumbing, just a bucket under the toilet that catches everything. Seriously, is this the way things were when Derek lived there? Because I can't see Meredith standing for that, and I especially can't see the Chief dealing with that well when he had his own RV parked up there for a while. But it's the way it is now, and Alex is upset that Izzie is trying to sell it like it's an adventure, just the two of them, married and exploring the wild. Cristina's just upset that it was so easy to get out the tick, but she snaps to when Alex declares that they are moving back to Meredith's. She tells him they can't do that, it's not how it works, and that Izzie's been through hell and isn't okay yet. "Just give her one, Alex." Alex asks her when she became a marriage counselor and Cristina thinks a moment before admitting, "I guess when you save someone's life, you kind of want it not to suck."
Arizona and Callie are eating lunch in a park overlooking the city, and as Arizona chats about how she loves the Seattle weather, Callie pulls out a list she made for Richard of 50 reasons to hire her back. She starts to read them and Arizona quietly puts her food away and says she's going back to the hospital. Callie, apparently also now oblivious to any nonverbal cues from others, tells her it's important despite the fact that Arizona is clearly kind of over it all. Arizona replies by telling her how her favorite scrub nurse, a single mother, was just fired and how in a surgery this morning she had to tell another nurse what to do, whereas her girl would have just known. She says that it was horrible to be there without her, so she thought a nice lunch with her girlfriend would be just the ticket. Callie apologizes, and Arizona tells her that Richard will either say yes or no, and then they'll know and can go from there. Callie settles down and rests her head on Arizona's shoulder.
Mere joins Derek, who is looking at scans of the optical glioma. He asks her if she's up for it and she says that she is, then jumps right into the real situation at hand and tells him that everyone is looking at her like she owes Thatcher something, but he's still the bad guy. Derek declares simply that she doesn't owe him anything and leaves the room, and when Mere turns to say something she finds Lexie in the doorway. She looks shattered and tells Mere she's surely going to be fired for a bunch of dumb things she did that day, including pulling Mere's medical record. Mere is clearly disappointed but Lexie plows on that she'd hoped to find that Mere wasn't a match (via blood type) and then she could just move forward, but of course Mere does appear to be a match. Lexie then starts to plead, saying she knows Thatcher wasn't there for her and she'd never ask Mere to give him anything. At this point, Mere is just watching Derek and his patient through the window, her eyes filled with tears. Lexie starts to cry as she begs Mere to give something to Lexie instead: her dad. Because as awful a father as he was to Mere, he was an amazing father to Lexie. Meredith sighs and finally looks at her sister as she details the recitals and graduations he attended. She again begs Meredith, "Give me my dad!" and Mere just looks back at Derek, who looks back. After a moment she glances up at Lexie and gives a tiny nod to herself, while looking equal parts angry and sad.
Meredith is staring at Thatcher when he wakes up. Matter-of-factly, she tells him that they found a match and will do the surgery that night. He's pleased but more confused than anything, given that they told him he wasn't eligible from the list. Quickly, like ripping off a band-aid, Mere tells him that it's not from the list, it's from her. Thatcher is rendered speechless as she tells him she was tested and is an ideal match, so she's going to go get herself admitted so they can do it. She turns to leave and he calls after her as best she can; when she comes back he tells her that he did this to himself, and therefore can't and won't let her fix it. He put her through enough already, and while it's totally generous it's an offer he can't accept. At least he has the wherewithal to admit that.
Hunt and Izzie have clearly given Randy and Angela the news that they couldn't do anything, because Angela is railing against them for just sending him home to die. Randy assures her they are doing all they can but Izzie is clearly building up a righteous fit, and asks to talk to Hunt outside. Once there she suggests various procedures they might try, but he has a very good reason why not to try each of them. He points out that Randy has a 13% survival rate, so he won't put him through another painful surgery. Izzie counters smugly that she had a 5% survival rate, and that she's alive because no one told her they'd done all they could. She hits him where it hurts pointing out that Cristina is the one who fought for her, and that this guy deserves a chance to fight. Hunt's not pleased and storms away without answering.
Meredith is pleased with herself for being a big person and offering, but is even more pleased that Thatcher turned her down. She tells Alex about it, and instead of congratulating her for her generosity he tells her she has to go back and make him accept. In one of his flashes of married-man maturity he reminds Meredith that he's the sick one and she's not, and tells her that she has to try again.
Derek then sees her sitting in the hallway, then pacing, clearing mulling it all over. Cristina comes by and sees her but Derek stops her from going to Mere, realizing she has to do this on her own. They watch as she continues her pacing and pondering.
Mark has run all of Irving's bloodwork, and like Mere he's clear for surgery. Doc Abbott is appalled, and asks if his father is really going through with it. When Irving says he is, however, Doc drops his bomb. He says that if Irving does this, he and his wife are taking him out of the home and moving him to their house to share a bedroom with pretty-but-dumb Janie. Irving doesn't want to, but his daughter-in-law condescends that the home is clearly causing him to make irrational decisions, and that seeing a younger woman and sneaking into her room is not appropriate at his age. Mark finally can't take it anymore, both for Irving and because that last comment hit a little close to home, methinks. He yells at them, "Come on! It's just an erection!" He points out that this is their father, who did everything for them, and now they are throwing it in his face. He asks if they know how many people would give up everything without blinking for their parents. And, he adds that there is nothing wrong with dating a younger woman as it keeps you young (in his professional opinion). Irving just looks at the kids, clearly pleased with all of Mark's points.
Richard is at Thatcher's bedside, and he's not so sick he can't get in a dig, asking if the Chief is always this attentive or just to patients whose wives he had an affair with. Thatcher apologizes, and then asks how he did this to himself. In this week's PSA (I don't mean to belittle the point he's about to make -- AT ALL -- but things do take a weird ABC Afternoon Special turn for a moment. Richard explains how he would wake up and promise himself that last night was the last drink, and then once he made it a little while sober he'd "reward" himself with more. He reminds Thatcher that this is a disease, and when he's in it he can't stop. That said, Mere is offering him a second chance, and he needs to take it if he wants to live. Tears roll down Thatcher's face as he replies, "I took her childhood. I can't take anymore from her." He then tells Richard to take care of Mere and Lexie. "You owe me at least that." Even near death, these two are never going to forgive.
It seems that despite his storming off, Hunt listened to Izzie and she happily tells Alex that she's going back into surgery because of that right now. She then stops to ask him if he's okay and say she's sorry about the tick. He puts on as realistic a happy face as he can muster and assures her it's a small price to pay for fresh air. She happily kisses him and doesn't notice his strained face as she leaves. But I applaud him for taking Cristina's advice to heart and at least trying.
Mere is still mulling over her decision in the hallway, but as Derek continues to watch her she seems to make a decision and walks away.
Her destination is Thatcher's room, and Lexie is there with him to hear what she has to say. She tells him, with no sugarcoating, that all she remembers about Thatcher is that he's the guy who would pour her cereal, and that his dying wouldn't change her life much. However, it would absolutely break Lexie, and she won't let him do that. She doesn't know much about having a father, "But I do know what it's like to have a sister. And it's good." She also tells him that if they get through this, the door will be open for them to get to know one another. Lexie crumbles, but this time they are happy tears. And my heart is definitely warmed -- I love how they've come along with this relationship between the sisters, and I love that it's now this good.
Boys will be boys -- Mark is showing an impressed Derek and Hunt how the pump works in an empty conference room. Hunt asks if there's a risk with his age, and Mark replies that there's always risk, but this is the most technologically advanced solution to the problem. Cristina happens to be walking by at just that moment, and leaps to action at the idea of a technically advanced surgery. Hunt tries to warn her that she doesn't want this, but as Mark hides the apparatus with his hand Derek says he thinks this would be a real challenge for her. Mark asks if he thinks she could handle it, and she jumps in like a puppy about to accidentally pee on the floor that she can handle it. Derek challenges this but she assures him she can handle it, and Hunt watches this all unfold with a nervous smile. Mark gives her the room number and tells her to go handle the pre-op. She beams, thanks him, and runs out and Hunt admits that he's going to pay for this later but that it was worth it.
Cristina, meanwhile, marches into the room and unceremoniously boots the other doctor, announcing that Sloan wants her on the case. The guy leaves, and Cristina greets Irving but her face falls as she looks at the chart and tells him she'll be getting him ready for his penile implant surgery. It turns out the other doctor was just about to shave him. Cristina's horrified, but sucks it up on account of her wanting a surgery so badly and tells him, "Terrific."
She then joins Mere, who is being wheeled to the OR, and Mere doesn't hide her glee at the whole situation, reminding Cristina it's all her own fault. She tells her at least she's not going to be in bed recovering for the month. And man, I have to say that's kind of a brilliant solution to the Ellen-Pompeo-pregnant situation -- she'll be off recovering, and we don't have to deal with some manufactured Mere-Derek drama again to explain her absence. In fact, Derek then shows up in scrubs, as he didn't plan to let her go through this by herself. Bailey hears him and tells him there's no way, and then shoos Cristina off to her own surgery. Derek is firm that he's just going to sit by Meredith's head and won't say a word. He respects that it's Bailey's OR but it's also his wife. She thinks about it, and seems to finally give in to the request (or polite demand, however you choose to interpret it).
Randy is on the gurney, ready to go under, but first he admits to Izzie that he wasn't waiting for the right moment. She guesses correctly that he was waiting to go into remission, and he explains that he didn't want to tie Angela to a sick husband. He's realized now that it's probably part of the package, so he's not going to waste another moment. Izzie says he shouldn't, and he smiles before they put him under. I suppose they must have had a talk with him we didn't see about how this is a risky surgery -- at least that's how Hunt made it sound -- but they both seem to be taking for granted that he's going to wake up fine and dandy afterward.
Bailey looks at Mere asleep on her operating table with Derek holding her head. She leans in and warns that she's had five interns, and four of them have now been on her table. "One of you has cancer, one of you died. You better not pull anything funny on me, Grey." She's stern, but obviously, despite her vowing to not give away any of her emotions or feelings at work anymore, she is Bailey and she's awesome and she can never detach completely. She and Derek exchange a look, and she makes a cut.
The scenes artfully cut between the three simultaneous surgeries. First, Hunt looks right at Izzie as he starts to take out Randy's staples. Once they are wrist-deep in him, though, alarms start to ring and they try desperately to save him. They can't, though, and over the single note of his flatline, Hunt glares at a shocked Izzie before pulling off his mask and storming out.
door, they are nearly done with the penis surgery and Mark tells Cristina that as senior resident, she gets to test the apparatus but he'll understand if she wants to pass. Cristina sucks it up and tells him she doesn't pass, and even though it might be a joke to them she does her job. She then announces, "Squeezing the scrotum." As the other attendings did before, the men all properly appreciate this most sacred of actions with breathless awe.
Bailey takes out a piece of Mere's liver with no drama or complications, but there's drama enough in the room when Thatcher seems to crash during surgery. Richard is performing the surgery himself, and doesn't appreciate it when Alex reminds him that he can't let this particular man die. Bailey then goes out to the lobby, where Lexie is asleep in Mark's arms. He says he doesn't want to wake her if it's bad news, but Bailey tells him to wake her up. So Richard was able to come through after all.
Hunt and Izzie are in the elevator on the way to let Angela know the results. Izzie is sad, while Hunt is angry that Randy had a couple of months and that they just took it away. Izzie tries to take the blame but Hunt won't let her, he says he made the wrong call, he should have known better, and he should have taught better. He does tell her that she wasn't ready to be put on this case, and that even though she beat the odds, she was the one in a million. He warns her that she can't be both a doctor and patient; she has to choose. He then gets out and goes to Angela, and as Izzie watches Angela sinks sadly into a chair before the elevator doors close.
Irving wakes up to find Mark in the room, and when he asks how it went Mark tells him he doesn't think he'll be disappointed. Just then, Doc comes to the door along with an older woman, and Irving happily introduces Mark to Marian. Everyone is beaming that it all worked out well, but I think Irving and Marian are happiest of all, clearly.
Richard is splashing water on his face after the surgery when Cristina comes in to confront him. Despite his warning her that it's not the time -- it's "not the time" all the time these days, and it's old -- she announces that she has good hands, made to do complex surgeries, and she should have been working on a heart saving a life rather than removing a tick and putting a pump in a penis today. Richard wearily asks for her point. She's surprised by the question, and then announces that he should just cut her from the program, because if he can't provide a cardiothoracic surgeon that can teach her, then she can't get what she needs here. It's like the penis pump flipped a maturity switch in Cristina, and instead of just being twitchy and angry, she finally is rational and well-spoken about her situation. She tells him that she's scared of losing her job but she's more scared of not learning and not using her "gift." (Gag.) "That's my point sir." He just watches her then leave, seemingly unaffected by her speech.
Angela is still in the chair in the lobby, frozen with grief, when Izzie finds her. In a rush, she tells her to open the mouth guard case at home, then apologizes for her loss and flees. Mere VO's: "We take one little oath, and suddenly we're drowning in obligations.
"To our patients, to our colleagues, to medicine itself." Callie is looking at Richard in the conference room, who is in his usual pose of staring blankly out the window. She asks him if he's okay, and he tells her what he clearly wants to shout at all of his employees: That it's his responsibility to make the hospital the best medical facility it can be, and to repair what he's broken, even if that was 20 years ago. Wait, is that responsibility taking I hear? It can't be. "If I am now the bad guy, if I am now the villain here, well... so be it." Callie tells him sincerely that it must be really hard for him, and that makes him turn and finally notice her. He thanks her, and she starts to ask but changes her mind and turns to leave, telling him to take care. But since she offered him some sympathy, he repays her with a job. He tells her to go down to HR and tell them she's an attending surgeon who needs a new badge. He then also tells her to take some Danish home, as they'll just go to waste. He shuffles out, and Callie smiles to herself at her luck.
"So we do what any sane person would do. We run like hell from our promises, hoping they'll be forgotten." Mere probably doesn't mean "run" literally, but that's just what Izzie does when she walks out the door the day to go to work and encounters the bear. Alex, still in bed, looks incredibly pleased and asks her if it was a deer. She declares that they have to move -- because, you know, if it's a problem for Alex it's stupid but if it affects Izzie, it's life.
"But sooner or later, they always catch up." Derek looks into Mere's room, where she's sleeping while Lexie dozes in a chair to her, with her head on Mere's bed. When she wakes up, Lexie does too and she immediately asks how she's doing and if she needs anything. Mere asks if she slept there all night, and Lexie admits she went back and forth between her room and Thatcher's, and that he's doing well too. She then says Lexie's name, and when Lexie hopefully asks what, Mere points out that she's on her IV. It's silly, but really quite sweet, actually. Mere wraps us up: "And sometimes, you find the obligation you dread the most isn't worth running from at all."